Antibiotics may alter baby’s metabolism

August 25, 2014 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

antibiotics alter baby metabolismIf young mice are given antibiotics early in life, they have a greater chance of becoming obese, a new study out of NYU Langone Medical Center found.

Researchers discovered that when they gave mice antibiotics during a critical part of early development, the bacteria or microbes in the mice’s guts were reprogrammed.

Scientists say disrupting the bacterial makeup of the gastrointestinal tract could affect the way the body’s metabolism works. A slow metabolic rate could lead to obesity, because the body doesn’t burn calories as quickly.

gut bacteria antibiotics probiotics“We found that when you perturb gut microbes early in life among mice and then stop the antibiotics, the microbes normalize but the effects on host metabolism are permanent,” says senior author, Dr. Martin Blaser, director of the NYU Human Microbiome Program and professor of microbiology at NYU School of Medicine.

“This supports the idea of a developmental window in which microbes participate. It’s a novel concept, and we’re providing direct evidence for it.”

The study authors stress that more evidence is needed to determine whether antibiotics could lead to obesity in humans, and that the study results should not keep doctors from prescribing antibiotics to small children when necessary.

Reference:

Cox, LM et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell. 2014 158 (4): 705–721.

 

Turning genes on and off

August 19, 2014 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

Transcription_factors_Fezf2

Neurons are a bit like people: though they share some common features, they can vary greatly in appearance and function. Proteins called transcription factors determine how neurons look and act by turning genes in the cells on and off.

In the picture above, scientists labeled a transcription factor called Fezf2 (in green) in cells in the motor area of the mature mouse cortex. Neurons in the layer above (in red and blue) did not express Fezf2. The grey cells show how neurons change shape after Fezf2 is expressed, growing highly complex extensions called dendrites.

Dendrites and axons transport electrical and chemical messages in and out of a nerve cell, enabling neurons to communicate with one another with incredible speed and precision.

The intricate branches, or arbors, of these extensions are what give neurons their beautifully strange and varied shapes. Dendrite arbors, for example, make some neurons look like sea coral, others like spider webs, and still others like round balls of tumbleweed. Axonal arbors are equally diverse. They can have a simple T shape and be quite short (less than one inch). Or they can be multi-branched and stretch, as do the axons of the sciatic nerve that run along the back of the thigh, for as long as three feet.

By studying the structural diversity of neurons, scientists are gaining greater insight into how the brain and the rest of the nervous system works.

Reference:

Tantirigama ML, et al. Expression of the developmental transcription factor Fezf2 identifies a distinct subpopulation of layer 5 intratelencephalic-projection neurons in mature mouse motor cortex. The Journal of Neuroscience. 2014 34(12):4303-8.

Cushing’s Disease

spondylolisthesisThis case is the hallmark of having a progressive, working diagnosis and not getting stuck on one idea.

Disease processes can progress rapidly and any hunch or potential red flag should warrant reexamination, a second opinion, blood tests, or new imaging such as X ray or MRI.

The patient presented with years of chronic right sacroiliac pain, numbness and tingling down the back of the leg, and difficulty lifting things. My concern at the time she presented for care was the recent onset of urge incontinence in the last year, which up until this time was only being treated by injection.

The underlying cause was more sinister – as was the cause under that cause.

Sometimes the symptoms of chronic back pain and changes in bowel and bladder function can be tied together by cauda equina syndrome, which is extreme pressure on the nerves of the lower spinal cord. If cauda equina syndrome is not dealt with appropriately, sometimes immediately by surgery, there can be permanent damage to the nerves that control the legs, bowel and bladder.

Other concerns the patient had were inability to lose weight, thinning hair, thinning skin that frequently got damaged and didn’t heal quickly, a change in facial colour and osteoporosis.

Initially, the patient gave me X rays from 2003 that were relatively normal (left). So the working diagnosis for the loss of bladder control was neurological at first. Whilst on holiday, she had a fall and the pain became progressively worse. I ordered a new set of films, shocked to find a double spondylolisthesis (right). A spondylolisthesis is the forward slipping of one vertebra on top of another. This process had occurred significantly over a 10-year period and was beginning to affect the function of the spinal nerves that controlled the patient’s bladder. It also accounted for the tremendous pain she was experiencing in her back and sacroiliac joint (hip).

spondylolisthesis x ray

I referred the patient to an orthopaedic surgeon for further investigation and an MRI. The first surgeon she saw suggested that this problem had probably been with her since childhood. The above X rays proved otherwise, so I suggested she seek another opinion.

Further testing revealed high levels of cortisol, which marked the beginning of the chief diagnosis and real underlying cause of all her health problems: a tumour on the pituitary gland, resulting in Cushing’s disease.

cushing's diseaseA pituitary tumour tells the adrenal gland to pump out more and more cortisol, which is the same stuff stress is made of. Cushing’s disease (as opposed to Cushing’s syndrome) is difficult to differentiate from people under major stress or those taking lots of asthma medication because they may exhibit the same bodily signs.

However, when cortisol levels become high enough, certain signs and symptoms become significant: Bruises, long term abdominal obesity, fullness of the face, facial hair and acne, purplish linear markings on the lower abdomen and gluteal region, weakness and fatigue, limb weakness, thin skin, loss of memory and bone degeneration.

Long term stress and cortisol has detrimental affects on overall health for 4 reasons.

Physical, emotional and chemical stress, as well states of constant pain, tell the adrenals to produce more cortisol. Over time excess cortisol does 4 things:

  1. Stress depresses cartilage and bone formation, leading to osteopenia and osteoporosis.
  2. Stress inhibits inflammation, which is a bad thing because wounds don’t heal.
  3. Stress depresses the immune system, lending one to chronic illness.
  4. Stress causes changes in heart, nerve and gut function, leading to all sorts of issues.

After many working diagnoses and eventually finding the cause, the patient was referred for surgery to remove the pituitary tumour. We wish her a speedy recovery ■

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